Heart failure, comorbidities, and polypharmacy among elderly nursing home residents

Michalik, Cyprian; Matusik, Paweł T.; Nowak, Jan A.; Chmielowska, Katarzyna; Tomaszewski, Krzysztof A.; Parnicka, Agnieszka; Dubiel, Marzena; Gąsowski, Jerzy; Grodzicki, Tomasz

doi:10.20452/pamw.1682

Cited by 20 publications

(28 citation statements)

References 5 publications

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“…Physical limitations have been mentioned most often as barrier to physical activity in at least one study [13]. Nursing home residents may suffer from diseases such as heart failure, a disease that often coincides with other diseases and with the use of multiple medications [14]. Polypharmacy is a known phenomenon among nursing home residents and is also related to, among others, ischemic heart disease, depression, and pain [15].…”

Section: Introductionmentioning

confidence: 99%

Setting-related influences on physical inactivity of older adults in residential care settings: a review

et al. 2017

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BackgroundDespite the detrimental effects of physical inactivity for older adults, especially aged residents of residential care settings may spend much time in inactive behavior. This may be partly due to their poorer physical condition; however, there may also be other, setting-related factors that influence the amount of inactivity. The aim of this review was to review setting-related factors (including the social and physical environment) that may contribute to the amount of older adults’ physical inactivity in a wide range of residential care settings (e.g., nursing homes, assisted care facilities).MethodsFive databases were systematically searched for eligible studies, using the key words ‘inactivity’, ‘care facilities’, and ‘older adults’, including their synonyms and MeSH terms. Additional studies were selected from references used in articles included from the search. Based on specific eligibility criteria, a total of 12 studies were included. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT).ResultsBased on studies using different methodologies (e.g., interviews and observations), and of different quality (assessed quality range: 25-100%), we report several aspects related to the physical environment and caregivers. Factors of the physical environment that may be related to physical inactivity included, among others, the environment’s compatibility with the abilities of a resident, the presence of equipment, the accessibility, security, comfort, and aesthetics of the environment/corridors, and possibly the presence of some specific areas. Caregiver-related factors included staffing levels, the available time, and the amount and type of care being provided.ConclusionsInactivity levels in residential care settings may be reduced by improving several features of the physical environment and with the help of caregivers. Intervention studies could be performed in order to gain more insight into causal effects of improving setting-related factors on physical inactivity of aged residents.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-017-0487-3) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Setting-related influences on physical inactivity of older adults in residential care settings: a review

et al. 2017

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“…Our results show that older patients with heart failure or diabetes mellitus (or both) were often overtreated and required deprescribing due to a distorted risk-benefit trade -off, which was confirmed in other studies. 9, 31 We showed that the GEM approach doubled the positive correlation between the number of concurrent diseases and the number of prescribed medications. Accordingly, a geriatrician acts as a conciliator between of new disorders in treated patients (eg, hypovitaminosis D 3 , hypovitaminosis B 12 , depression, dementia, pain syndromes), we showed that in real -life practice deprescribing outweighed prescribing.…”

Section: Inpatient Characteristics As Potential Explanatory Fac-mentioning

confidence: 92%

Prescribing or deprescribing in older persons: what are the real-life concerns in geriatric practice?

Bień¹,

Bień-Barkowska²

2018

Polish Archives of Internal Medicine

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INTRODUCTION Multimorbidity in older adults leads to polypharmacy with all its hazardous outcomes and drug‑related problems. OBJECTIVES We aimed to assess the difference in the number of drugs between admission to and discharge from a geriatric ward and identified the patient‑related factors associated with changes in the drug regimen. PATIENTS AND METHODS This retrospective cross‑sectional study included 301 geriatric patients who underwent drug optimization in line with the Beers and STOPP/START criteria. The numbers of drugs per individual at hospital admission and discharge were compared using the Wilcoxon signed‑rank test. A multiple linear regression model was used to identify patient characteristics that influenced the observed difference in the number of drugs following geriatric hospitalization. RESULTS A significant reduction of 1.29 in the number of drugs per patient, on average, was observed. The Spearman's correlation coefficient between the number of prescribed medications and the number of coexisting conditions per individual changed from 0.28 to 0.51. The patient‑related characteristics that jointly and independently explained (P <0.001) the difference in the number of drugs in the multiple regression model (R2 = 0.73) were the number of drugs on admission, number of coexisting conditions, age, fact of living alone, and the incidence of adverse drug reactions. CONCLUSIONS Geriatric hospitalization results in deprescribing rather than prescribing medications, especially in individuals who were overtreated, older, undernourished, at risk of an adverse drug reaction, and living alone. Appropriate deprescribing may potentially lead to fewer drug‑related problems in the senior population as well as reduce health care costs.

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“…38,39 It is considered to play a crucial role in the pathophysiology of heart dysfunction. 40 The interaction between kidney and heart diseases is bidirectional and is known as cardiorenal syndrome.…”

Section: 2945mentioning

confidence: 99%

Prognostic value of novel biomarkers compared with detailed biochemical evaluation in patients with heart failure

Rywik¹,

Janas²,

Klisiewicz³

et al. 2015

Polish Archives of Internal Medicine

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Heart failure, comorbidities, and polypharmacy among elderly nursing home residents

Cited by 20 publications

References 5 publications

Setting-related influences on physical inactivity of older adults in residential care settings: a review

Setting-related influences on physical inactivity of older adults in residential care settings: a review

Prescribing or deprescribing in older persons: what are the real-life concerns in geriatric practice?

Prognostic value of novel biomarkers compared with detailed biochemical evaluation in patients with heart failure

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